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Ruth May becomes senior nurse at new regulator and made deputy CNO

Ruth May has been confirmed as executive director of nursing at the new regulatory body NHS Improvement.

Dr May has also been appointed as one of two new deputy chief nursing officers for England – along with Hilary Garratt, currently the director of nursing for NHS England.

“Clinical expertise will be at the heart of our work”

Jim Mackey

The new regulator NHS Improvement, which is currently being set up from two existing regulatory bodies plus several departments from other government arm’s length bodies, has today announced a number of senior appointments.

Dr May is currently nursing director at Monitor, one of the two regulators that are being merged to form NHS Improvement. The other regulator in the merger is the NHS Trust Development Authority. Its director of nursing is Peter Blythin.

NHS Improvement will formally come into being on 1 April 2016. It will be responsible for overseeing foundation trusts, NHS trusts and independent providers.

In a statement announcing a number of senior appointments at NHS Improvement, its chief executive Jim Mackey said: “Clinical expertise will be at the heart of our work.

“We’ll also be establishing networks of clinical leaders across the service to work alongside our medical and nursing directors,” he added.

Dr May has been at Monitor since July 2015. She was previously an influential member of NHS England’s national nursing leadership team, holding the post of regional chief nurse and nurse director for the Midlands and East region for around two years.

While at NHS England, she led work on the key action area of staffing and skill mix for the Compassion in Practice national nursing strategy.

Prior to her appointment at NHS England in October 2012, she held a similar regional role as nurse director for the now defunct NHS Midlands and East strategic health authority. She was also a member of the Prime Minister’s Nursing and Care Quality Forum.

Welcoming the appointment of Dr May,chief nursing officer for England Jane Cummings said: “Ruth has already made a valuable contribution to nursing in this country and I welcome her to the new role of director of nursing for NHS Improvement.

“I am also delighted to announce that Ruth and Hilary Garratt, the director of nursing for NHS England, have been appointed deputy CNOs for England,” said Ms Cummings.

“These new appointments will help strengthen our national leadership for nursing and I look forward to working closely together in the future,” she added.

The chief nursing officer for England’s new framework for nurses, midwives and care workers has been welcomed by leaders among the profession, who have praised it for its attention to public health, in particular.

The chief nursing officer for England has unveiled a new four-year plan for nurses, midwives and care workers focussed on how the profession can drive changes to services and help reduce unwarranted variation in health and care provision.

NHS workforce supply problems will continue for the next “few years” and, despite additional funding to transform services locally, significant financial efficiencies will still be required, the head of the health system’s new regulator has said.

Nurse staffing decisions should be based on a “measure and improve” approach to raise care quality rather than the current “guide and comply” method, according to the most senior nurse at the health service’s newest regulator.

Leading nurses have raised serious concerns about a loss of vital nursing expertise and influence over policy at the highest level after the Department of Health outlined proposals to cut up to 700 jobs.

NHS costs have been driven up by trusts taking a “mechanistic” approach to nurse to patient ratios in hospitals, which was not the intention of the body that produced the safe staffing guidance, senior health figures have told MPs.

Levels of care provided by nurses in hospitals have only just returned to the same as those last seen at the end of 2011, according to a report by regulators revealing the extent of nurse staff shortages in England.

While the acute trusts/primary care struggle on with more &amp; more work &amp; more &amp; more regulations with less &amp; less money that makes it almost impossible at times to see your way through the working day the 'wider' NHS continues to employ more at massive salary's. You have to ask yourself what value &amp; influence on patient care at the sharp end do these people add???? Where is the budget capping &amp; reductions the salary alone of the exec team must be around 800-900k. Would we notice if they went tomorrow"..........I don't think so.

Top heavy approach good sign of cutting staff numbers in the name of ever improvements sounds like more Lean Care Deletism and ever expensive quality empire building (another known weakness of the government non-profits friendly americanised approach) - baffle the front line with double speak of empowerment and blame them when all goes wrong and so boot them out based on false improvement and behavioural tools rather than resource or environment problems. What a bag of nonsense and the best bit is were all starting to see through it. We know your game govenrment and you'll facebook based on your lack of understanding of culture and Good sense.

I was shocked I Iooked through each person on the list and they all have something to do with lean. This is scary stuff would we be right in saying these are the hatchet men and women of the NHS? And you have a point what happens when improvement is not possible? Is it management denial of stagnation and its denial thus blaming staff and getting them to face false performance criteria to get rid of them when the going gets tough. How do we educate nurses to stand up to this right wing use of American lean? The unions need to mobilise quickly in order to safeguard the safety of patients and staff very quickly if we are to stand a change against what you call Lean Care deletism. I'm very frightened that government and management are becoming both enemy of the profession and patients, how can we stop them?

There is perhaps a way at floor level of overcoming interfering politics and Jeremy Hunt, and false improvement - where proven, but if right it is not in a traditional sense of resistance, it is at its best disruptive in a progressive way. Below are some ideas for thought only:

1. Understand the forums used to sell potentially false government products are potentially in part a form of government/CEO propaganda and ego creation all mixed in one - it is the first premise to determine whether true empowerment (understand your CEOs are not superman).

2. Can such empowerment be used to regularly overload QI Depts and limiting fixed variables with other relevant variables, for example with understanding of human freewill to inappropriate measurements &amp; keep doing it. Also query expense of QI Depts where expanding at cost of staffing numbers, there maybe evidence that lean for example is notorious for ever increasing QI Depts and expense, where appropriate monitor NHS improvements as an example of this. In fact an NHS Improvement dept is not arguably cost saving thus one big criticism to start with.

3. Question where appropriate report incidents in team agreement with an understanding where appropriate of your environment/ setting and not simply human behaviour - risks and incidence are not necessarily defined by process performing.

4. Understand the sources of the method to perhaps debate the contradictions. but also for example keep putting forward how waste could be opposite and concepts to be provided to everyone such as Gemba, standing in circles and Kaizen. An analogy would be giving management tools to everyone - watch to see if it makes them uneasy.

5. Don't get lulled in to arguments of widgets and car factories, even though you might be right, they potentially love this one. Remember though even car corporations get cars sent back due to faults in the first place, but yes you and everyone aren't cars even though the comparisons maybe good.

6. If good put forward repeatedly only where appropriate the need to ascertain connection between task overload and measurements with retention and high turnover rates. Is there a connection?

7. Put forward where appropriate well-being concerns such would this be introducing OCD like presentations, stress and such where there is over reliance on measurements - how would this effect family well-being?

8. Look to other countries like America and Canada to see what has occurred. - Union movements against similar government initiatives.

9. Where stop watched understand the importance of right pace and not attempting faster and faster - don't eradicate or inappropriately be detrimental to your team members where time and not quality is put forward.

10. Measure your tasks against your ability to take quality breaks, we can see this weakness in recent reports of staff being pushed to work longer hours and more days where lean has been put forward. Also if management are terming quality patient time strictly in time of other tasks, question if this is thus by proxy direct measurement of time spent with patients.

Love the intellectual right and thoughts only of a rusty old hedge wizard.

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